Tag Archives: measles

While researching something else entirely I came across Dr Benjamin Moseley and an old controversy with very modern echoes.

Benjamin Moseley was born about 1746, son of Edward Moseley of St Osyth on the north Essex coast. On the 22nd of October 1765 he was granted the Freedom of the City of London by Redemption, paying forty-six shillings and eight pence for admission to the Company of Woolmen. His father was recorded as ‘Gent’ and, combined with the location of the family, this suggests that they had made their money as sheep farmers supplying fine English wool to the world.

Benjamin was trained as a doctor in London, Leiden and Paris and settled in Kingston, Jamaica about 1767, practising as a surgeon apothecary and eventually becoming Surgeon General. He also served as an Assistant Judge in the parish of St Andrew. On the 9th of January 1768 he married Martha Clare, by licence, in Spanish Town. Of their children only two outlived their father, a son William Henry born about 1777 who in due course followed his father into medicine as an Army doctor but who died only four years after his father; and a daughter named Martha Elizabeth born about 1781. Nothing more is known of Martha Clare who may have died in Jamaica.

There is an interesting note on the parish register for St Osyth – “At front: note of outbreak of smallpox from which 86 persons died, 1737-1738” (now held at the Essex Record Office in whose SEAX database I found it). St Osyth is a very small place, so the village memory of this disastrous event may have coloured Benjamin’s childhood. In any case when he arrived in Jamaica he would have become very aware of the devastating effect of smallpox epidemics.

Normal mortality in such epidemics was about 30 percent, although a milder form had only a one percent mortality, however there was a hemorrhagic form that was almost invariably fatal. No wonder then that a slave who could be certified to have had the disease and have recovered, usually evident from the sometimes terrible scarring it caused, commanded a higher price. By the second half of the eighteenth century most planters were having all their slaves inoculated.

While there was little that could be done to treat the disease once caught, knowledge of inoculation had spread from China, India and the Arab world into Europe by the eighteenth century. The technique involved taking some of the pus from the lesions of an infected person and introducing it into the person to be inoculated via a small cut or scratch. Sometimes the person doing the inoculating would travel around taking the sick person with them to provide live material. Sometimes dried matter was used and was inhaled. The result was that the person being inoculated caught smallpox, but usually in a mild form, from which they recovered in a couple of weeks or so. However there were fatalities. One high profile death was that of the young Prince Octavius, son of George III who had all his children inoculated.

At the end of the eighteenth century Edward Jenner made a scientific study of inoculation using cowpox – hence the new term vaccination – first inoculating with cowpox and then testing its efficacy by infecting his subjects with smallpox. The cowpox made them slightly unwell, and they failed to catch smallpox. In due course vaccination replaced inoculation with smallpox as being the safer option.

It was not however uncontroversial. Benjamin Moseley had written a number of treatises – on the benefits of coffee and sugar (in which he had a financial interest!) and on dysentery, another killer scourge in Jamaica especially amongst the troops stationed there. He has a small place in history however as a vocal and high profile opponent of vaccination.

He was not opposed to the principle of inoculation and like many doctors made a living using the traditional method. However the arguments against introducing animal matter into humans, mainly children, have a modern parallel in those who oppose, for example, the use of pig heart valves in humans. Although the notion featuring in cartoons of the time, that those vaccinated with cowpox might turn into cows seems extreme to us now, given that the understanding of disease and its causes was rudimentary, the anxieties are understandable.

According to Sam Kean, writing about a new video game teaching about vaccination, Moseley argued that vaccination would degrade people spiritually, making them near-brutes. Why, “owing to vaccination,” he wrote, “British ladies might wander in the fields to receive the embraces of the bull.” He even prophesied “a new Pasiphaë”—the mythological queen who had sex with a cow and gave birth to the Minotaur. Lisa Rosner, a historian at Stockton College helping develop the video game on vaccination, calls Moseley a talented demagogue: “He really had his finger on the pulse of what people are afraid of.”

Although eventually vaccination resulted in the world-wide banishing of smallpox in the wild to a small number of (hopefully) very secure laboratories, the same is not true of measles. Also an epidemic killer, routine vaccination, compulsory before school admission in some countries, has significantly reduced but not yet eliminated the disease. Recent outbreaks in the UK have been attributed to a scare a decade ago, echoing Moseley, that the vaccine could cause autism. That claim has been totally discredited but a generation of children grew up who had neither had measles nor been vaccinated, with the result that mass vaccination is now being offered to those who had missed out in order to contain the spread of what can be a fatal illness.

Benjamin Moseley had built up a large and wealthy clientelle in England based around his Jamaican connections. This gave him both influence and access to the means of widely publicising his views. Similarly in the MMR vaccination scandal in the UK, access to media, happy to play on the natural fears of parents who only want the best for their children, facilitated the spread of a scientifically discredited theory. It seems little had changed in two hundred years.

A late 18th Century embroidered mourning scene for a young child worked on an ivory silk ground. The stylized scene includes a central tombstone with the inscription written in ink on silk: ‘In memory of Mifs Betsey Thomson who died Jun 29 1794 aged 4 years’*

I recently took some time off to look after a grandchild with chickenpox, and it was borne in on me how much things have changed even during my lifetime. A mere half century or so ago all children in the UK could expect to catch measles, mumps, whooping cough, German measles, chickenpox, and possibly scarlet fever or rheumatic fever, and to be vaccinated only against smallpox and diptheria. Many would die from polio and meningitis. Only when I was almost out of primary school did the Salk vaccine arrive from America to immunise against polio, which my sister had caught as a baby and I too had probably suffered from. In secondary school I was vaccinated against TB and tetanus, and already antibiotics were available to fight bacterial infections and pneumonia, saving many lives. My Scottish great grandmother lost only one of her twelve children – little Catherine died at eleven months of Cellulitis, Septicaemia of the arm an infection probably resulting from a small scratch or insect bite, which now would be easily treatable.

Now every child in the West, and many in the developing world, can expect to be vaccinated against virtually all of these childhood diseases and new vaccines are coming on stream all the time. However we should beware of becoming complacent since antibiotic resistance is becoming more and more common, and if it becomes entrenched we may find ourselves in a similar position to the parents of small children in 18th-century Jamaica.

There was for a time a strand of academic thought that claimed that because infant mortality in the past was so high, and so many pregnancies and infants were lost, that parents were inured to it and did not care for their small children unprepared to make any ‘investment’ in them until they grew up and were likely to reach adulthood.

I really do not believe this. Take for example the death of little Charles MacKay, which was mentioned recently on the Facebook group of the Jamaica Colonial Heritage Society, following the discovery of some marble tomb fragments from a site that had been bulldozed. The gravestone had sadly been lost but it had previously been recorded and so we know that so precious was little Charles Mackay that he was not recorded as being simply two years old at his death but precisely two years five months and twenty-seven days.

Here lies Interred

The Body of Charles MacKay

The Son of

Hugh MacKay by his Wife Frances

Born on the 14th of November, 1751, Dyed on the 21st of May, 1754

Aged 2 Years, 5 Months and 27 Days

Oh! Early loss. Like some fair Flower, the pleasant Spring supplies, That gayly Blooms, but even in blooming dies. Memento Mori. O Death, all Eloquent you only prove, What Dust wee doat on when tis man wee love

Browsing through Philip Wright’s Monumental Inscriptions of Jamaica (Society of Genealogists 1966) shows that many children were commemorated with their ages given to the day in this way.

It is hardly surprising that parents, faced with the repeated loss of children born in the British colonies, sent them back to Britain in the hope that their chances of survival would be greater. This was a practice not only among 18th-century Jamaican parents, but one which continued throughout the nineteenth and into the early twentieth century. My own grandfather and his siblings were sent back from India to school in England, not because the schools were so much better but because their health was likely to be improved.

More heartbreaking was the position of Lady Nugent, whose diary of her Jamaican experiences is well known[1]. Having apparently lost several pregnancies she had two children born in Jamaica with whom she returned to England. When they arrived her health had been so debilitated that she weighed a mere six stone, and when subsequently her husband was posted to India she left her four surviving children including a five week old baby behind in England for the sake of their health.

She wrote of her pleasure at her husband’s new appointment, But alas! I cannot help thinking of my children; and, while I am going through all the bustle of dinners, to meet East Indians, etc and while I am fatigued in both body and mind, with writing and various preparations, my whole heart is at Iver and at Westhorpe; for ten days ago, my dear little girls returned there, under the care of dear good Miss Dewey. I am impatient to get out of town to them…

And later she wrote, This book I shall seal up, and send to Westhorpe to be put into the desk, that is in the little breakfast room, where my dear children may find it, one of these days, should I not return; and along with it various little articles, as keepsakes, which they will value, I am sure, as relics of the father and mother, devoted to their interest and welfare.

The Nugents did return safely to England and spent the rest of their lives with the four of their children who survived to grow up. Because of their social position and Lady Nugent’s Journal we know more about them than about many of Jamaica’s colonists and their children.

Often we can only deduce the deaths of children when we read a Jamaican Will that leaves an estate to nieces and nephews, distant cousins or friends, from which it can be assumed that no immediate heirs had survived. Such children were often buried on the planter’s estate in a family plot and it was not uncommon for the grave to be unmarked, the grave marker lost or the death and burial to have gone unrecorded in the parish register. This makes it difficult to estimate levels of child mortality. How much more difficult is it to estimate mortality among Jamaica’s slaves and their children, particularly in the earlier part of the 18th-century for which fewer plantation records survive.

What can be said with certainty is that malaria, smallpox, yellow fever, measles and other infections killed adults and children alike. Poor hygiene and a lack of knowledge of how infection was spread, or understanding of the role of mosquitoes in transmitting malaria and yellow fever, meant people were unable to take preventive measures and survival was often due to luck rather than a strong constitution.

[1]Lady Nugent’s Journal of her residence in Jamaica from 1801 to 1805. New and revised edition edited by Philip Wright, Institute of Jamaica, Kingston, 1966.

The colonists who went to Jamaica in the 17th and 18th centuries were aware of many of the risks to their health but not of the causes. Much has been written about the reasons why white society in Jamaica never became established to the same extent as it did in North America in spite of the fact that the Caribbean islands were regarded as part of the same territory.

It is notable that of the early colonists who arrived with Penn and Venables from 1655 onwards few had descendants still on the island a century later. Very many marriages were terminated within a short time by the death of one partner. Infant and maternal mortality even by the standards of the time was shockingly high, and more than one colonist died at sea fleeing the island for the sake of their health. Of the eight children of the Rev William May featured in an earlier article only one survived to full adulthood, with two sons aged fifteen and twenty dying at sea on their way to Boston “for the recovery of their health”. Young girls seem to have married earlier on average than their equivalents back home in England, and it is likely, quite apart from the shortage of young white women in Jamaica, that this was at least in part an attempt to ensure the production of children before their parents’ anticipated early death. Visitors to the island noted with shock that few of the tombstones recorded Islanders who had made it past their early thirties.

The reasons for the very high infant mortality included waterborne infections such as diarrhoea and dysentery, measles, smallpox, whooping cough, and especially in the case of infants born on the plantations to enslaved mothers infantile tetanus (known as lockjaw). This disease whose spores are transmitted through animal faeces nearly wiped out the population of the Scottish island of St Kilda in the 19th century, until the local minister studying a course on midwifery prevented the anointing of the baby’s cord with sheep dung. On the Jamaican plantations where women carried baskets of dung on their heads to manure the sugar cane, such knowledge and choice was unavailable. There is no record of the number of babies who died in this way but it must have been high.

Infections such as measles, smallpox and whooping cough were no respecters of colour or class but there is evidence of appallingly high mortality among slaves newly arrived in Jamaica. Their health already compromised by dehydration, poor food, lack of fresh air or exercise and suffering from grief and depression, those on the lower tiers of a slave ship spent the voyage unable to avoid the urine and faeces of those above them. If they survived the voyage they too easily succumbed to epidemic diseases on arrival. It was generally the practice to “season” new arrivals allowing a period of acclimatisation often by working on the pens tending livestock or producing provisions before they were put to work in the cane fields or at the more skilled and exhausting tasks in the boiling houses.

Major epidemics killed white settlers and slaves alike, with regular outbreaks of yellow fever, measles, smallpox and yaws all of which were highly infectious. There is evidence that on some plantations it was realised that the slaves themselves were better at treating yaws, with which they were familiar from their home countries, than the European doctors who prescribed mercury itself a poison and used by them to treat the related condition of syphilis[1].

Yellow fever had probably arrived in the West Indies from Africa by the mid seventeenth century. Like malaria it is dependent for its transmission on mosquitoes breeding in stagnant water, both then present in abundance in Jamaica. The clay pots used in sugar production when broken were cast down and provided small pools of water; hurricanes and earthquake tsunami created larger bodies of water ideal for breeding.

Following the disastrous earthquake of June 1692 a correspondent of Sir Hans Sloane wrote on the 23rd of September, “We have had a very great Mortality since the great Earthquake (for we have little ones daily) almost half the people that escap’d upon Port-Royal are since dead of a Malignant Fever, from Change of Air, want of dry Houses, warm lodging, proper Medicines, and other conveniences.”[2]

Another wrote “The Weather was much hotter after the Earthquake than before; and such an innumerable quantity of Muskitoes, that the like was never seen since the inhabiting of the Island.”

In addition to infectious illness with high mortality Jamaica’s inhabitants had to contend with problems caused by ticks and jiggers. Blood sucking ticks particularly attack bare flesh around the legs and infected bites could lead to more serious problems. Jiggers, or chigoe fleas, bore into the feet to lay their eggs and were particularly problematic for anyone without shoes, which of course was most of the enslaved population as well as some poor whites. It was important to remove the jiggers early in their life cycle using a specially designed knife, and many cases of lameness among slaves were attributed to the lesions from untreated jiggers. They could also attack the hands, and any part of the person exposed to the ground, such as legs or buttocks. Many plantations carried out weekly hand and foot inspections.

Europeans arriving in Jamaica recognized smallpox and dysentery, measles and whooping cough but yaws, tropical ulcers, the dry bellyache and miscellaneous fevers were new to them. Most were infections against which there was little remedy but the dry bellyache should have been avoidable by the mid-eighteenth century when its cause was understood to be lead poisoning resulting from the stills used for making rum.

Benjamin Franklin “wrote about lead poisoning on several occasions, in particular about a disease known as the dry-gripes (or dry-bellyache) that had plagued Europe and the colonies for years….in 1723 the Massachusetts colonial legislature passed a bill outlawing the use of lead in the coils and heads of stills. Observance of this law led to vastly decreased incidence of the dry-gripes, as the population drank less and less lead-contaminated rum.” [3]

In 1745 Thomas Cadwalder had drawn attention to the extreme cases of colic ‘West India dry gripe’ that were caused by the use of lead piping in rum distillation, but it seems nothing was done and it is not clear when the use of lead was reduced in Jamaica, with large scale illness and death among the garrisons and in the navy still occurring at the end of the eighteenth century. The better off colonists avoided the worst of this by drinking imported claret, brandy or Madeira as well as rum, but excessive use of alcohol leading to liver damage further weakened their ability to withstand illness and live to see old age.

One notable exception was Jane Gallimore born about 1664, who outlived her husband Matthew Gregory by nearly forty years and whose burial record in St Catherine in 1754 gave her age as ninety. Mary Bailie was buried on 22nd July 1756 when her age was recorded as ‘about 95’.

Many colonists chose not to risk the hazards of Jamaica once they had established their plantation, or made their fortune as merchants and left the island for ever hoping thereby to live a long and healthy life ‘back home’.